Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $33.90 / $177.23 / $620.79	Facility		$33.90	$177.23	$620.79
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $8.19 / $8.19 / $8.19	Facility	26	$8.19	$8.19	$8.19
Aetna Facility/Professional Facility Modifier TC Low / Median / High Price $25.72 / $25.72 / $245.74	Facility	TC	$25.72	$25.72	$245.74
Aetna Facility/Professional Professional Modifier Low / Median / High Price $18.80 / $30.26 / $68.53	Professional		$18.80	$30.26	$68.53
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $7.43 / $9.11 / $30.60	Professional	26	$7.43	$9.11	$30.60
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $21.35 / $27.65 / $69.30	Professional	TC	$21.35	$27.65	$69.30
Cigna Facility/Professional Professional Modifier Low / Median / High Price $60.90 / $74.47 / $93.08	Professional		$60.90	$74.47	$93.08
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $13.96 / $17.07 / $21.33	Professional	26	$13.96	$17.07	$21.33
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $46.66 / $57.40 / $71.75	Professional	TC	$46.66	$57.40	$71.75
Medica Facility/Professional Facility Modifier Low / Median / High Price $37.92 / $48.52 / $57.31	Facility		$37.92	$48.52	$57.31
Medica Facility/Professional Professional Modifier Low / Median / High Price $34.72 / $57.91 / $204.50	Professional		$34.72	$57.91	$204.50
Medica Facility/Professional Professional Modifier 26 Low / Median / High Price $10.08 / $15.60 / $74.30	Professional	26	$10.08	$15.60	$74.30
Medica Facility/Professional Professional Modifier TC Low / Median / High Price $24.71 / $41.18 / $176.00	Professional	TC	$24.71	$41.18	$176.00
Midlands Facility/Professional Facility Modifier Low / Median / High Price $56.00 / $66.64 / $108.68	Facility		$56.00	$66.64	$108.68
Midlands Facility/Professional Facility Modifier 26 Low / Median / High Price $27.50 / $27.50 / $27.50	Facility	26	$27.50	$27.50	$27.50
Midlands Facility/Professional Facility Modifier TC Low / Median / High Price $69.48 / $69.48 / $69.48	Facility	TC	$69.48	$69.48	$69.48
Midlands Facility/Professional Professional Modifier Low / Median / High Price $55.00 / $66.64 / $80.95	Professional		$55.00	$66.64	$80.95
Sanford Health Plan Facility/Professional Professional Modifier Low / Median / High Price $35.32 / $46.85 / $62.10	Professional		$35.32	$46.85	$62.10
Sanford Health Plan Facility/Professional Professional Modifier 26 Low / Median / High Price $10.33 / $13.05 / $15.21	Professional	26	$10.33	$13.05	$15.21
Sanford Health Plan Facility/Professional Professional Modifier TC Low / Median / High Price $24.74 / $35.21 / $47.22	Professional	TC	$24.74	$35.21	$47.22
United Facility/Professional Professional Modifier Low / Median / High Price $34.79 / $46.30 / $57.98	Professional		$34.79	$46.30	$57.98
United Facility/Professional Professional Modifier 26 Low / Median / High Price $9.19 / $15.17 / $17.64	Professional	26	$9.19	$15.17	$17.64
United Facility/Professional Professional Modifier TC Low / Median / High Price $26.84 / $41.18 / $43.24	Professional	TC	$26.84	$41.18	$43.24
Wellmark Facility/Professional Professional Modifier Low / Median / High Price $54.80 / $64.50 / $64.50	Professional		$54.80	$64.50	$64.50
Wellmark Facility/Professional Professional Modifier 26 Low / Median / High Price $13.10 / $15.40 / $15.40	Professional	26	$13.10	$15.40	$15.40
Wellmark Facility/Professional Professional Modifier TC Low / Median / High Price $41.70 / $49.00 / $49.00	Professional	TC	$41.70	$49.00	$49.00